TOPICS > Health

FDA plan to limit painkiller abuse may have impact for patients who need them

October 25, 2013 at 12:00 AM EST
While millions of people use prescription painkillers for relief, their abuse has reached epidemic levels in some places. To combat rising addiction rates, the FDA has a new plan to limit the distribution of pain meds, specifically containing hydrocodone. Hari Sreenivasan gets more from Barry Meier of The New York Times.
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JUDY WOODRUFF: The use of prescription pain killers has grown substantially in the U.S., providing relief to millions, but addiction to the drugs is also on the rise. More than five billion pills were prescribed to nearly 50 million people in 2011, according to the most recent government estimates. Now regulators want to set new limits on how they are used.

Hari Sreenivasan looks at what the government wants to change.

HARI SREENIVASAN: The painkilling drugs in question contain the narcotic hydrocodone. It’s often found in brand-name drug such as Vicodin or Lortab. The FDA said yesterday that abuse of them has reached epidemic levels in some parts of the country and announced plans to change the way the drugs can be prescribed and refilled.

Barry Meier of The New York Times has the details. He’s long covered this subject and is the author of an e-book called Painkiller.

So, Barry Meier, kind of lay out the changes. What is the FDA thinking about recommending?

BARRY MEIER, The New York Times: Sure.

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 The biggest change here is that the FDA is recommending that doctors prescribe these drugs in the way that they are only available for a 90-day supply to patients. Previously, they had been available for as long as six months. And now patients will have to bring in these prescriptions, rather than have the doctor phone them in.

So it’s both the reduction in the amount that doctors can prescribe, and kind of the logistics of getting patients to bring them in.

HARI SREENIVASAN: So these drugs have been around for quite some time now. What is the problem that the FDA is trying to address? Has it gotten worse?

BARRY MEIER: Actually, it has gotten worse.

I mean, it’s always been fairly bad. But it’s increased significantly in recent years. There are huge supplies of these drugs kind of washing around in the society. A lot of them are used for legitimate pain control purposes. But because you have got this huge inventory out there, many of them end up on the street.

Kids go into medicine cabinets and steal them. So what effectively is being done here are efforts to crank down on the supply and hopefully reduce their misuse and abuse as a result.

HARI SREENIVASAN: And besides the problem getting worse, why is it acting now? This is a conversation that has been debated over time by quite a few people.

BARRY MEIER: Right.

It’s a very good question. I think there is increasing political and public health pressure on the FDA that has essentially spurred this action. I mean, they — as recently as earlier this year, they were claiming at public meetings that the kind of scientific equations that would cause them to make this determination have not changed.

So it’s their kind of belatedly getting on the train that public health advocates have been on for many, many years.

HARI SREENIVASAN: And so let’s talk a little bit about the impact that it’s going to have on people who legitimately need this, who aren’t using this for an abusive purpose.

BARRY MEIER: Right.

It will have impacts on those patients. That can’t be denied. I mean, essentially, this is going to impact people living in rural areas who don’t have access to many doctors, older people who may be housebound, and people in nursing homes who can’t run down to the drugstore and fill a prescription.

And in states — there are some states where nurse practitioners who previously could prescribe these drugs will not be able to do so unless state laws themselves change.

HARI SREENIVASAN: So do most patients that are using these drugs the right way, are they on these drugs for an extended period of time?

BARRY MEIER: Well, most patients who get these drugs are actually on them for a very short period of time, maybe 14 days or so.

The people who take them longer — and that’s usually considered greater than 90 days — many of them are taking them legitimately. Some of them are dependent or addicted to the drugs. And, essentially, what this will do will require these drugs — patients to see their doctors more often. And that may be a good thing, because while these drugs are intended to reduce pain, you want people with these problems to also increase their function, get out more in society, resume their work. And doctors will be able to check on that.

HARI SREENIVASAN: So what’s the pushback likely to be? We have got — on one hand, we have got the pharma companies, we have got doctors, we have got patients groups. They’re all in opposition of these recommendations.

BARRY MEIER: I think there is still going to be significant pushback.

The government, however, seems to be fairly committed to this course. So in terms of affecting the government decision in this area, that may be done for now. So you will have pushback on the state level, in terms of making sure that people who can prescribe these drugs now are still able to do so, and hopefully changes that will make sure that these drugs are still available to people in situations like nursing homes who need them.

HARI SREENIVASAN: All right, Barry Meier from The New York Times, thanks so much.

BARRY MEIER: It’s been a great pleasure.